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PDE-5 Inhibitors

Most Effective Oral Drugs For ED Treatment

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What are PDE-5 Inhibitors?

PDE-5 Inhibitors (PDE5i) are oral medicines used primarily for curing erection problems (ED) in male persons. The introduction of these drugs has revolutionized treating of males with ED of any etiology and severity.

Advantages of PDE5i include:

  1. High safety profile. PDE5i can cause adverse effects, but their incidence is low and they are usually insignificant.

  2. High effectiveness. Inhibitors of PDE-5 ere effective in approximately 70-80% of males.

  3. Reversibility. PDE5i act during a short time (typically up to 6 hours) and are rapidly excreted from the body. They don’t cause addiction.

  4. Convenience of using. Before the invention of PDE5i, the potency was often treated with injections in the penis. Therefore, effective oral tablets have become a real sheet anchor for male persons with ED.

  5. Providing natural feelings. PDE5i grant fully natural erection for sexual intercourse.

PDE-5 inhibitors can also be used for treating prostate ailments as well as pulmonary hypertension.

How Do PDE-5 Inhibitors Work?

pde5 inhibitors

Following sexual arousal, PDE5i improves blood current in the male organ. Erection occurs as a result of blood’s filling the penis: arteries (which deliver blood) expand, and the veins (through which the blood outflows) narrow. In healthy men, sexual excitement causes the formation of NO (nitric oxide) which leads to the production of cGMP substance that is responsible for arteries’ dilation. PDE5i blocks a PDE5 enzyme that hampers the activity of cGMP. Thus, PDE5i medicaments prevent decay of cGMP causing prolonged penis engorgement.

It’s important: PDE5i don’t increase libido in males, they just activates natural mechanisms of penile erection occurrence.

How To Use PDE-5 Inhibitors?

PDE5i should be taken 20-120 min before anticipated sex. Fatty food products can delay the onset of their effect therefore try to not combine the medicaments with high-fat meal (this does not apply to Cialis). Usually, treatment starts with a minimal dose of the drug (for example, Levitra in 10mg tablet strength In the absence of efficacy, the strength may be increased (only if such it is prescribed by a healthcare professional). It should be noted that the insufficiency of one drug should not be the reason for not using other PDE5i. For example, Levitra can help patients who have not obtained the desired effect from Viagra.

Warning: never use PDE5i if you take medicaments containing nitrates. Combinations of nitrates & PDE5i may cause rapid drop in arterial pressure that may even lead to a lethal outcome.

Types Of PDE-5 Inhibitors

The first PDE-5 inhibitor, Viagra, was released in 1998. At the beginning of 2000s it was joined by Cialis and Levitra that became main competitors of Viagra. Several years ago, the drug market began to be filled with other drugs from this family, such as Stendra, Zydena, etc.

The medicines differ in:

  • onset of effect;
  • duration of action;
  • individual tolerability of a patient;
  • compatibility with fatty food.

But in general, action of PDE5i drugs is similar.


Canadian Viagra is the most widespread and most famous PDE5i medicament. It’s based on sildenafil citrate key agent and produced by Pfizer company in the form of blue diamond-shaped tablets with branded inscriptions. It’s the most researched drug among all PDE5i medicines. All information about this blue pill you can find here: Viagra


Generic Cialis (tadalafil) is produced by Eli Lilly US in the form of yellow or light-yellow tablets that look like an almond. It features unprecedented duration of action – 1.5 days (i.e. thirty-six hours). The remedy may be taken “as needed” or on daily basis.

Levitra & Staxyn

Levitra (vardenafil) is a bright orange pill manufactured by Bayer. Vardenafil is superior to other PDE5i remedies due to the rate of achieving the maximal effect. Another vardenafil-containing brand drug is Staxyn that is produced in the form of sublingual tablets.

Stendra & Spedra

Stendra & Spedra are the newest anti-ED medicaments based on avanafil main agent. These bright-yellow tablets are produced by Vivus Inc. Avanafil provides quick effect; but by other characteristics it does not differ much from other inhibitors.

Other Drugs


Some other types of PDE5i are available in particular countries of the world. For example, lodenafil (brand-name Helleva) is marketed in Brazil. Residents of Russia, Philippines and Korea can buy udenafil (Zydena) in their countries. Mirodenafil is available as Mvix medicine in Korea. However, all of the above drugs have not been approved in the USA & other countries. Therefore, little is known about them.

What To Choose: Brand Or Generic?

Any PDE5i medicament has brand (genuine) and generic versions. Genuine versions are usually produced by developers of a particular drug and are protected by a patent that prohibits other companies to manufacture this product until the patent ceases to have effect. Then any drug maker can manufacture products with the analogous active agent, but under a different brand-name. They also may differ in color, shape, packaging, and labeling. These medications are called generics. Research shows that generics provide the same efficiency as their branded “parents”, while they are much cheaper.

Why? Generic drug-makers bear much less expenses on manufacturing, as the medicament has already been invented, developed, and checked by a brand-name producer.

Related Article: Compare Brand and Generic Viagra types.

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